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Query: UMLS:C0038379 (strabismus)
 9,317 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Scleroderma, "en coup de sabre" is a rare disorder, characterized by linear depressed scarring at frontoparietal area of the face, seldom associated with ophthalmological findings. Extraocular muscle involvement and paralytic strabismus are rarely associated with linear scleroderma. Here we are reporting a case of unilateral linear scleroderma in an 8-year-old child, with features of strabismus fixus secondary to fibrosed medial rectus (MR) muscle, enophthalmos and en coup de saber (sword-like scar) on the eyebrow. MRI orbit was suggestive of the bulky MR and the inferior rectus muscle. MR recession along with partial loop myopexy resulted in cosmetically acceptable ocular alignment in this case. Histopathology of the portion of muscle and intermuscular septum showed diffuse fibrosis of the muscle. Linear scleroderma may be the causative etiology of strabismus fixus in our case, never reported before in literature.
Strabismus 2019 12
PMID:A case of linear scleroderma "en coup de sabre" with strabismus fixus in a child. 3154 71

A 24-year-old male athlete, injured by a cricket bat during training, was transferred to the hospital with an open head bleeding trauma in the medial part of his right eye. He was conscious, with no memory loss and dizziness. A medial orbital wall fracture (MOWF) with a foreign body presence was depicted in X-ray. Head computed tomography scan confirmed initial diagnosis and revealed the complete fracture of ethmoid sinuses. Temporary sutures were placed initially to close the wound and prevent trauma's infection. The ophthalmological exam revealed strabismus of the right eye due to medial rectus muscle entrapment and consequent diplopia in the horizontal gaze. After two weeks, surgery was planned to remove the foreign body, restore eye mobility, and correct diplopia. The wooden foreign body (2.5cm x 1cm) was removed with immediate decompression of the medial rectus muscle. The fracture was repaired by an open approach, a mesh net was placed and sutured to the periosteum for bone stabilization and regeneration. Fifteen days postoperatively, visual acuity was 10/10, ocular mobility was normal, and diplopia disappeared. Imaging is essential in diagnosis' confirmation and reconstructive surgery planning, without postoperative complications and complete patient's rehabilitation. The current report highlights the value of reconstructive surgery in orbital structures' preservation in complex MOWF cases. In such cases, the foreign body that entraps medial rectus muscle should be removed in time in order to prevent the orbital content displacement towards the gap created by the fractured bone with consequences enophthalmos and diplopia, as well as consecutive intraorbital infections. Eye preservation in the correct position eliminates strabismus.
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PMID:A Medial Orbital Wall Fracture From Cricket Bat During Training: Surgical Approach. 3321 49


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